Culture/Spiritual Taylor Chapter 5

cultural diversity

(1) coexistence of different ethnic, biological sex, racial, and socioeconomic groups within one social unit; (2) diverse groups in society, with varying racial classifications and national origins, religious affiliations, languages, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location

A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the: a. media. b. past history. c. genetics. d. nursing personality.

A Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media. None of the remaining options play a role in the client's comment to the nurse.

A nurse is admitting a client to the unit. Which cultural question is most appropriate? a. "What are your dietary needs and preferences?" b. "Will you be able to eat the normal food provided?" c. "Will you be making requests for special food based on your religion?" d. "Do you have food restrictions?"

A By asking about dietary needs and preferences, the nurse can gain insight into religious and cultural dietary practices. Asking about "normal" foods assumes that a cultural dietary request is abnormal. The other options will produce limited insight and imply that a cultural dietary need is a restriction or hindrance.

A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply. a. Health disparities b. Improved access to care c. Increased economic privileges d. Less power e. Greater advantages

A, D The term minority refers to a group of people within a society whose members have different ethnic, racial, national, religious, sexual, political, linguistic, or other characteristics from most of society. Being of a minority group often results in having less power and being disadvantaged, including health disparities in a society. Greater advantages, improved access to care, and economic privileges are not associated with minorities.

A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority? a. Blood sugar assessment b. Language assessment c. Spiritual assessment d. Blood pressure assessment

B Although all of the assessments are appropriate, the priority assessment is communication. If clients do not speak the dominant language, it may be necessary to obtain an interpreter to provide culturally appropriate care.

The staff nurse overhears the charge nurse, who is of Italian heritage, talking to the unlicensed assistive personnel. Which statement made by the charge nurse is an example of ethnocentrism? a. "Hispanics are usually lazy." b. "Italians are best at everything." c. "Asian people are bad drivers." d. "People who are Irish are usually alcoholics."

B Ethnocentrism is the belief that one's cultural is better than other cultures. Therefore, the statement "Italians are the best at everything" demonstrates ethnocentrism. The other options are examples of stereotyping. Stereotyping is a fixed attitude about people who share common characteristics.

A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early." What cultural factor can the new nurse assess from this conversation? a. Cultural conflict b. Stereotyping c. Cultural blindness d. Cultural imposition

B The charge nurse is clearly exhibiting ageism, which is a form of stereotyping. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one's own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes one's cultural beliefs onto another person.

cultural imposition

tendency of some to impose their beliefs, practices, and values on another culture because they believe that their ideas are superior to those of another person or group

Which behaviors demonstrated by the client would the nurse consider reflections of the client's pride in ethnicity? Select all that apply. a. Crying when given a diagnosis of cancer b. Listening to folk music and dance c. Asking to wear unique clothing d. Requesting native cuisine e. Requesting assistance when transferring from bed to chair

B, C, D Pride in one's ethnicity is demonstrated by valuing certain physical characteristics, giving children ethnic names, wearing unique items of clothing, appreciating folk music and dance, and eating native dishes. Feeling emotional when given a concerning diagnosis and asking for assistance do not reflect pride in ethnicity.

cultural blindness

the process of ignoring differences in people and proceeding as though the differences do not exist

An older adult client who only speaks the nondominant language has been admitted to the emergency department after suffering a fall and suspected hip fracture in the home. Who is the best person to perform translation services for the client? a. a trusted friend b. a family member c. a bilingual hospital employee d. a hospital translator

D A qualified interpreter who is familiar with health care terminology is the best choice for providing translation for clients. Such a person is more likely to be objective and well versed in the requisite vocabulary than is a friend, family member, or hospital employee.

culture shock

those feelings, usually negative, a person experiences when placed in a different culture

linguistic competence

ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in a health care encounter

stereotyping

assigning characteristics to a group of people without considering specific individuality

ethnocentrism

belief that one's own ideas, beliefs, and practices are best, superior, or most preferred to those of others; using one's cultural norms as the standard to evaluate others' beliefs

cultural competence

care delivered with an awareness of the aspects of the patient's culture

race

division of human beings based on distinct physical characteristics

cultural respect

enables nurses to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients; critical to reducing health disparities and improving access to high-quality health care

personal space

external environment surrounding a person that is regarded as being part of that person

subculture

group of people with different interests or goals than the primary culture

cultural assimilation

process that occurs when a minority group, living as part of a dominant group within a culture, loses the cultural characteristics that made it different

transcultural nursing

providing nursing care that is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing the diverse cultural populations within our society

culture conflict

situation that occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values

A client's spouse has asked that the client be cared for exclusively by female nurses. How should the nurse incorporate this request into the care plan? a. Document the request and make all reasonable efforts to honor it b. Determine whether the request is based on a valid reason or cultural preference c. Document the request as a knowledge deficit and address the couple's educational needs d. Assess the couple's rationale for making the request

A Although cultural assessment in a tactful and respectful manner is likely appropriate in this situation, the care team's guiding principle and obligation should be to accommodate and respect the couple's request. It would be inappropriate for the care team to attempt to convince the couple to change their minds or assume that it is a personal preference. The nurse would not teach the couple that male nurses on the unit are empathetic, as having female nurses is the client's preference.

Which is a cultural norm of the health care system? a. There is the use of a systematic approach and problem-solving methodology. b. The omnipotence of technology is yet to be recognized. c. There is a tolerance of tardiness, disorderliness, and disorganization. d. There are rigid procedures attending birth and death.

A Cultural norms of the health care system include the use of a systematic approach and problem-solving methodology; the omnipotence of technology; the dislike of tardiness, disorderliness, and disorganization; and the use of certain procedures attending birth and death.

The nurse cares for a client who is a member of a different culture from the nurse's. Which question is most important for the nurse to ask to assess the client's beliefs about treatment? a. "What are your expectations about being in the hospital?" b. "How do you feel about being in the hospital?" c. "What do you believe about health care?" d. "What do you eat for breakfast?"

A Culture is defined in many ways, but at the broadest level, it can be understood to be a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. It is important for the nurse to realize that people are individuals who may or may not ascribe to the norms of his or her culture. Asking what the client's expectations for treatment are specifically assesses beliefs. The client may not eat a diet from his/her culture.

Persistent gaps between the health status of minorities and non-minorities are defined as: a. health disparities. b. ethnocentrism. c. cultural relativity. d. racism.

A Despite continued advances in health care and technology, racial and ethnic minorities continue to have higher rates of disease, disability, and premature death than non-minorities. These differences are known as health disparities. Racism is the belief that one's race is superior to another. Ethnocentrism is the belief that one's culture is superior to another. Cultural relativity is the belief that an understanding of a person's behavior depends, at least in part, on an understanding of that person's cultural context.

When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing: a. ethnic identity. b. subculture. c. race. d. assimilation.

A Ethnicity or ethnic identity refers to a self-conscious, past-oriented form of identity based on a notion of shared cultural (and perhaps ancestral) heritage and current position in larger society. Race is based on biologic characteristics; assimilation refers to new customs and attitudes that are acquired through contact and communication among persons of a particular culture; subculture refers to a group of people within a culture who have ideas and beliefs that are different from the rest of that society.

The clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond? a. "Collecting this information allows us to develop a personalized plan of care to meet your needs." b. "Understanding your background will prevent us from doing anything to offend you." c. "Insurance companies requires us to ask all clients." d. "We require the information for identification purposes"

A Identifying and understanding the client's ethnicity will assist the nurse and healthcare team to develop and provide individualized culturally competent care. Ethnicity is not used for client identification. Insurance companies may request this data; however, it is not the priority reason for the nurse to collect the data.

The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client? a. The interpreter should understand the health care system. b. The interpreter should speak in a loud voice. c. The interpreter should always make direct eye contact. d. The interpreter should conduct the conversation quickly to avoid e. misinterpretation.

A Obviously, nurses cannot become fluent in all languages, but certain strategies for fostering effective cross-cultural communication are necessary when providing care for clients who are not fluent in the dominant language. Cultural needs should be considered when choosing an interpreter; however, it is also important to use an interpreter who understands the health care system. In choosing an interpreter, the nurse should not select one who speaks in a loud voice, conducts the conversation quickly, or always makes direct eye contact. Direct eye contact is regarded differently among cultures.

A preconceived and untested belief about an individual or group of individuals is: a. stereotyping. b. cultural relativity. c. racism. d. culturally competent care.

A Stereotypes are exaggerated descriptors of character or behavior that are commonly reiterated in mass media, idiomatic expressions, and folklore. Racism is believing that one's race is superior to another. Culturally competent care is care that involves an awareness of one's own cultural beliefs and biases and an understanding of how a client's culture affects the client's health care. Culture relativity is the belief that an understanding of a person's behavior depends, at least in part, on an understanding of that person's cultural context.

A client is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation? a. The client's child learned the dominant language as a second language. b. The client enjoys watching television programs from the home country. c. The client does not speak the dominant language and requires an interpreter. d. The client and child cook traditional foods for the family.

A The child is demonstrating an example of cultural assimilation by taking on the language of the dominant culture. When a minority group lives within a dominant group, its members may adapt some of their cultural practices that once made them different. This process is referred to as cultural assimilation. Watching television from the home country, cooking traditional foods, and speaking only the original language demonstrate the original culture and an attempt to bring the minority culture into the dominant culture.

A nurse who usually works on the surgical unit is asked to float to the oncology unit because of staffing needs. Which statement by the nurse indicates the possibility of the nurse experiencing culture shock? a. "I am very stressed now because I do not understand how things work on this unit." b. "Can someone please give me an orientation to this unit?" c. "The way we do things on the surgical unit are so much better than the procedures of this unit." d. "I was expecting all the clients on the oncology unit to be depressed."

A The nurse is experiencing culture shock because of the new environment. When the culture one has learned differs from the culture in one's environment, a person can become disoriented and stressed. The acute experience of not comprehending the culture of the current environment is called culture shock. Asking for an orientation to a new unit is proper procedure for a float nurse. The third statement indicates ethnocentrism, not culture shock. The fourth statement indicates stereotyping.

A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert? a. Client b. Health care provider c. Older family member d. Nurse

A When gathering cultural information, the interviewee is the expert. Other family members may provide information about the culture, but the client is the expert. The nurse and health care provider are responsible for obtaining information related to the culture.

The nurse is taking a client history. With which client is direct eye contact appropriate? a. 32-year-old white woman b. 44-year-old woman of Asian descent c. 60-year-old woman of Arab descent d. 55-year-old Native American/First Nations woman

A White Westerners generally make and maintain eye contact throughout communication. Although it may be natural for whites to look directly at a person while speaking, that is not always true of people from other cultures. It may offend clients of Asian descent or Native Americans/First Nations clients, who are likely to believe that lingering eye contact is an invasion of privacy or a sign of disrespect. Clients with Arab heritage may misinterpret direct eye contact as sexually suggestive.

The nurse admits a client to the critical care unit to rule out a myocardial infarction. The client has several family members in the waiting room. Which nursing action is most appropriate? a. Assess the client's beliefs about family support during hospitalization. b. Insist that only one family member can be in the room at a time. c. Explain to the family that too many visitors will tire the client. d. Allow all the visitors into the room.

A Asking the client about the client's beliefs exemplifies that the nurse recognizes the importance of respecting differences rather than imposing standards. If the client believes family support is significant to health and recovery, the nurse should respect the client's beliefs and allow the visitors into the room.

Which term describes the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture? a. Cultural imposition b. Cultural blindness c. Cultural taboos d. Acculturation

A Cultural imposition is the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture. Cultural blindness occurs when one ignores differences and proceeds as though they do not exist. Acculturation is the process by which members of a cultural group adapt to, or learn how to, take on the behaviors of another group. Cultural taboos are activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group.

The younger nurses on a unit, who seem to adapt easily to the new technology presented, are perceived as threatening by two nurses who have worked on the unit for years. The older nurses begin to ridicule the younger nurses, saying, "You might be able to work a computer, but we know how to provide real care." How should the charge nurse respond? a. The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit. b. The charge nurse should demonstrate cultural blindness and pretend that the issue does not exist. c. The charge nurse should understand that this is stereotyping in the form of racism and intervene immediately. d. The charge nurse should recognize that this is cultural imposition and the younger nurses are forcing new technology on the older nurses.

A. The scenario presents a classic example of cultural conflict. The older nurses feel threatened by those who are technologically savvy and try to prove their value so that they feel more secure. Both parties have value, and the charge nurse can use knowledge of diversity to help bring cohesion to the unit.

When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate response? a. Move closer to the client. b. Ask the client about personal space preferences. c. Ask the client why he or she is backing away. d. Back away from the client.

B It is most appropriate to ask the client what is preferred in regard to personal space. If the nurse needs to invade the client's personal space to do an examination or take vital signs, it is important to discuss the matter. It is not appropriate to back away without assessing preference. It may make the client feel judged if the nurse asks why he or she is backing away. Moving closer to the client just perpetuates the problem.

Which nursing action displays linguistic competence? a. Asking a family member to interpret for a client who does not speak the dominant language b. Learning pertinent words and phrases in the client's language c. Repeating statements to a client who speaks only a language different from the nurse d. Speaking loudly to a client who does not speak the dominant language

B Linguistic competence is best displayed by learning pertinent words or phrases in the client's language. Speaking loudly and repeating words do not solve the communication barrier or show an effective response to a linguistic need. Asking the client's family to interpret is discouraged because it is often unreliable and leads to confusion for the client and the nurse.

The nurse is teaching a Black client about common health conditions. Which statement by the client most directly addresses a health problem with an increased incidence in this population group? a. "Getting a mammogram in my thirties is important." b. "It is important to monitor my blood pressure." c. "I need to watch the amount of high-density lipids I eat." d. "Increasing dairy will improve my bones."

B Monitoring the blood pressure is important for identifying the risk for hypertension and stroke, which are common health conditions among the Black population. The other statements are correct for preventing diabetes, breast cancer, and osteoporosis, but these diseases are not disproportionately common health conditions for the population.

A client who practices Islam dies at the hospital surrounded by family members. Which action by the nurse demonstrates cultural sensitivity related to the client's death? a. having the family members consult with the funeral home for transport b. consulting the family member prior to performing post-mortem care c. allowing the family to remain present when the nurse washes the client prior to shrouding d. informing the family members they may say their goodbyes so that care can be provided

B Only family members may touch or wash the body of a deceased individual who practiced the Islamic faith, so the nurse should ask for permission prior to providing post-mortem care. The family may choose to remain, but the nurse will not be allowed to wash the body. It will be the nurse's responsibility to arrange for transport to the funeral home after care is rendered by the family.

The spouse of a client asks the nurse whether the spouse may bring in a cream from home to apply to the client's skin. The spouse says, "Whenever anyone gets sick, we always use this cream." The nurse interprets this as: a. ethnocentrism. b. ritual. c. subculture. d. stereotyping.

B Rituals are common and observable expressions of culture in hospitals, clinics, homes, schools, and work settings. Clients and their families practice rituals that are intimately important to them, particularly during illness and hospitalization. Observance of rituals in times of stress and uncertainty helps restore a sense of control, competence, and familiarity, and to that extent it is a desirable adjunct to nursing care. Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media. In its mildest form, ethnocentrism presents as subconscious disregard for cultural differences; in its most severe form, it presents as authoritarian dominance over groups different from one's own. Stereotypes are preconceived and untested beliefs about people. They are exaggerated descriptors of character or behavior that are commonly reiterated in mass media, idiomatic expressions, and folklore. A subculture is "an ethnic, regional, economic, or social group exhibiting characteristic patterns of behavior sufficient to distinguish it from others."

A client has been admitted to the unit for chest pain. A nurse told the family that they could not be with the client. The family became very upset, and now the client wants to leave. What is the most culturally appropriate response by the charge nurse? a. "Why do you think you need to leave?" b. "Would you feel more comfortable with your family with you?" c. "Sometimes family can cause stress, and we try to maintain a stress-free care environment." d. "If you leave, you will be asked to sign a form indicating that you are leaving against medical advice."

B Some cultures are very family oriented; others may have members who are skeptical of modern health care. The request for the client's family to leave most likely frightened the client. Asking the client how to make the client more comfortable is the best option. Asking the client why the client wants to leave is judgmental, implying there is no real reason to leave. Citing the hospital's policy regarding clients who leave against medical advice is not culturally sensitive and does not address the client's concerns. Clearly in this client's case, having the family present reduces, not causes, stress, so the comment about maintaining a stress-free environment is not valid.

The nurse is admitting a client who practices the Jewish faith to the acute care unit and calls the dietary department to order a kosher dietary tray without consulting the client about food preferences. Which behavior is the nurse demonstrating when performing this action? a. stereotyping b. generalization c. ethnocentrism d. ageism

B The nurse is demonstrating generalization by ordering a kosher dietary tray when not all Jewish people keep kosher. The nurse is assuming that all Jewish people only eat kosher foods or all hold the same behaviors and beliefs. Stereotyping prevents seeing and treating another person as unique while generalizing suggests possible commonalities that may or may not be individually valid. The nurse is not demonstrating ethnocentrism, which is a belief that one's own culture or religion is superior to another. Ageism is the discrimination of a person due to their age and treating them differently.

Which statement best conveys the relationship between race and ethnicity? a. Race and ethnicity can be considered to be synonymous in the context of health care. b. Race denotes physical characteristics, while ethnicity is rooted in a common heritage. c. Race and ethnicity are both culturally determined concepts. d. Race is based on an individual's cultural history and is independent of ethnicity.

B The term "race" is usually used in reference to particular physical characteristics, while ethnicity is an identification with a cultural group that is often based on a common heritage. Because it is rooted in objective physical traits, race is usually considered to be somewhat independent of culture.

The nurse is preparing to administer prescribed medication to a client who is Native American/First Nations. The nurse enters the room and observes a tribal traditional healerperforming a healing ritual for the client. What action would be the most appropriate by the nurse? a. Administer the medication while the healer continues the ritual. b. Unless asked to stay, leave the room and return when the healer is finished. c. Ask the healer to leave the room. d. Wait in the room until the healer is done.

B Tribal traditional healers (sometimes referred to as shamans by western cultures) are tribal leaders or medicine men that are used in many Native American/First Nations cultures to relieve illness. The culturally competent nurse should allow privacy for the healing ritual and return when it is completed. The culturally competent nurse should incorporate the client's beliefs into the client's care, as long as the health belief and practice is safe. Administering the medications while the shaman continues the ritual or asking the shaman to leave may be perceived as disrespectful to the client.

The nurse is caring for a client diagnosed with asthma. The client reports drinking herbal tea to treat illnesses. Which additional question(s) will the nurse ask during the assessment? Select all that apply. a. "Can your family bring some tea to the hospital for you?" b. "Do you take any other supplements?" c. "Have you shared this information with your health care provider?" d. "Is there a specific brand of tea that you prefer?" e. "How many cups of herbal tea do you drink in one day?"

B, C, E Culture influences a client's dietary choices and the nurse should accommodate these preferences as long as it is safe to do so. Herbs are a common medicinal treatment in many cultures. If a client traditionally drinks herbal tea to alleviate symptoms of an illness, it would be appropriate for teas and prescribed medications to be used together as long as there are no contraindications. The nurse will need to determine how many cups of herbal tea are ingested each day along with any other supplements the client takes. The nurse does not need to determine the specific brand of tea the client prefers. It may be appropriate for family to bring the client herbal tea, but only after the nurse has determined there are no interactions with the client's prescribed medications. It is important to ask the client if he or she has discussed the use of the tea or any other supplements and alternative therapies with the primary health care provider. Since many alternative treatment modalities are not federally approved for use, there may be drug interactions that the client is unaware of.

A nurse is presenting an in-service program to a group of nurses about culture and cultural diversity. When describing culture, which characteristics would the nurse include? Select all that apply. a. Culture is predictable. b. Culture has recognizable patterns. c. Culture is logical to an outsider. d. Culture is dynamic. e. Culture is a set of traits.

B, D Culture is dynamic and always changing and it has recognizable patterns. It is not predictable, nor logical to an outsider. It is not simply a set of traits.

The nursing researcher is studying so-called "unnatural illnesses." What cause of such illnesses would be included in the study? a. Impurities in water b. Cold air c. Witchcraft d. Food

C "Unnatural illnesses" are thought to be punishments for failing to follow a god's rules, resulting in evil forces or witchcraft causing physical or mental health problems. "Natural illnesses" are thought to be caused by dangerous agents such as cold air or impurities in the air, water, or food.

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle? a. A culture's conceptualization of health promotion is a result of that culture's level of socioeconomic development. b. Health promotion is a concept that is largely exclusive to Western cultures. c. The client may have a very different understanding of health promotion. d. The nurse should avoid performing health promotion education if this is not a priority in the client's culture.

C As a component of cultural assessment, the nurse should seek to understand the cultural lens through which the client may understand health promotion. Health promotion is not a concept exclusive to Western cultures, though it may be considered differently among non-Western cultures. Even if health promotion is not a priority in a client's culture, the nurse should still address issues related to health promotion in a respectful and relevant manner. Health promotion is not directly linked to socioeconomic development levels.

A client from a minority culture has been hospitalized for 6 days for postoperative infection. The client's weight is decreasing each day, and the nutritional intake is declining. Which nutritional assessment question is most appropriate? a. "Are you aware that you are losing weight?" b. "Don't you like what is on your food tray?" c. "What type of food do you eat at home?" d. "Why aren't you eating your food

C Cultural food preferences often put the client at risk for inadequate nutrition. By exploring what foods the client eats at home, the nurse can assess the client's cultural dietary preferences and work to incorporate these foods into the meal plan. The other choices are judgmental and indicate that the client should eat what is presented regardless of cultural preference.

The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? a. "Language is the primary way that people share their culture." b. "Culture helps to define identity within specific groups of people." c. "Culture cannot be influenced, and you are born with your culture." d. "Culture can be seen in attitudes and institutions of certain populations."

C Culture is learned through life experiences from one generation to the next. Culture helping to define identity, language being the primary way that people share their culture, and culture being seen in attitudes of certain populations are correct options; these are all components that define culture.

When describing the concept of ethnicity, which statement would be most appropriate to use? a. Ethnicity is a present-oriented form of identity. b. Culture involves self-consciousness while ethnicity does not. c. Ethnicity allows people to define themselves and others to define them. d. Ethnicity is an alternative term that implies the same ideas as culture.

C Ethnicity is a cluster of ways for people to define themselves and be defined by others. It involves the selection of certain shared cultural characteristics, such as symbols of a common group origin, history, or descent. Ethnicity is not culture. Ethnic identity is distinguished from culture in that ethnic identity is self-conscious about select symbolic elements that are taken as the emblem of group social identity. Ethnicity or ethnic identity refers to a self-conscious, past-oriented form of identity based on a notion of shared cultural (and perhaps ancestral) heritage, as well as current position within the larger society.

When reviewing the chart of an older adult client, the nurse notes that the client identifies as Japanese. The nurse realizes the client is referring to which ancestral and cultural factor? a. race b. ethnocentrism c. ethnicity d. values

C Ethnicity refers to a common bond of kinship with country of origin, for this client Japan. Race refers to biologic differences, for this client Asian. Ethnocentrism is the belief that one's personal heritage is superior to others. Values are beliefs and attitudes that are important to a person. The scenario does not provide details to determine if the client expresses ethnocentrism nor any personal values.

A nurse is demonstrating ethnocentrism. Which statement would reflect this concept? a. "Anybody on welfare is just lazy." b. "Asians are always the smartest in the class." c. "My Russian heritage is superior to all others." d. "Irish people are all heavy drinkers."

C Ethnocentrism is viewing one's own culture as the only correct standard by which to view people of other cultures. Stereotypes are preconceived and untested beliefs about people. They are exaggerated descriptors of character or behavior that are commonly reiterated in mass media, idiomatic expressions, and folklore. They may be demeaning ("People on welfare are lazy, just living off handouts"; "Irish people are all heavy drinkers") or idealizing ("Asians are always the smartest in the class"; "Nurses are patient people"). Either way, they mislead and deny the individuality of the person.

A family has immigrated and settled in a neighborhood that primarily speaks their native language. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language? a. The 58-year-old father in the family who works in a nearby factory b. The 18-year-old daughter in the family who works at a restaurant in a neighboring town c. The 45-year-old mother in the family who does not work outside the home d. The 12-year-old son in the family who attends public school

C The 45-year-old mother will have the greatest challenge in learning the dominant language due to not working outside the home and living in a community that speaks the native language. Children usually assimilate more rapidly and learn the language of the dominant culture quickly because they leave home each day to go to school, making new friends in the dominant culture. Wage earners also tend to learn a new language more quickly through the work setting. Language acquisition is tied to necessity and assimilation, rather than to the degree of difficulty.

A family recently immigrated to a new country. The parent reports that the teenager is showing signs of fear, has vague reports of stomach pain, and feels humiliated by peers because of their culture. What is the priority assessment for the nurse? a. Cultural blindness b. Cultural assimilation c. Culture shock d. Cultural imposition

C The client is experiencing symptoms associated with culture shock. Culture shock occurs when a person is immersed in a different culture that is perceived as strange. The person may feel foolish, fearful, incompetent, or humiliated, and these feelings can lead to frustration and anxiety. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one's own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes his or her beliefs onto another person.

Which nursing intervention reflects culturally appropriate care when addressing a client? a. "I see you are here because you have a sinus infection." b. "Thank you for coming to the clinic today." c. "Good morning, Mr. Smith. I am your nurse, John." d. "You can sit in this chair, Sally."

C The nurse can demonstrate professionalism and culturally appropriate care by addressing clients by their last names and introducing oneself. The nurse should follow up thoroughly with requests, respect the client's privacy, and ask open-ended rather than direct questions until trust has been established.

A client who does not speak the dominant language has been admitted to the health care facility reporting chest pain. Because the assigned nurse does not know the client's language, what would be the most appropriate solution for communication until a professional interpreter can be obtained? a. The nurse should ask the supervisor for a different nurse to take this client that is fluent in the client's native language. b. The nurse should communicate with the client nonverbally and proceed with care as needed. c. The nurse should request the help of a family member if available, if not care should be administered that is in the best interest of the client. d. The nurse should get a language dictionary and attempt to translate basic information in order to obtain consent for treatment.

C The nurse should request the help of a professional interpreter to communicate effectively with the client who does not speak the same language as the nurse. If this is not readily available in an emergency situation, the nurse can ask a family member to help in basic communication if available. The nurse is responsible for providing care to stabilize the client regardless of language barriers. Trying to use a language dictionary to help communicate may be troublesome and time-consuming. The nurse cannot shun nursing responsibilities by asking for a different assignment or asking for a different nurse to take the case. Asking the client to communicate nonverbally may lead to a break in communication or misinterpretations.

The client is admitted to the hospital with a ruptured ovarian cyst. The client has expressed that it is very important that the spouse be present to receive all medical information. Using the concepts of culturally competent care, which is the best response? a. Bring the client's spouse into the hallway to discuss surgical options for the client. d. Document the client's request in the nursing care plan. c. Explain to the client that it is not a good idea to have the spouse in the room when discussing such a private matter. d. Explain to the client that the client is required to make all decisions related to the client's own health care.

D A culturally sensitive nurse is one who respects a client's requests while ensuring that the requests reflect safe medical practice. This client's request does not interfere with client safety. Thus, the request should be respected and communicated through documentation to other healthcare personnel. Telling the client that the client must make all health care decisions does not address the client's request. There is no need to move to the hallway to discuss the client's care with the client's spouse, and this would likely be offensive.

A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating? a. Cultural assimilation b. Cultural diversity c. Cultural blindness d. Cultural conflict

D Cultural conflict occurs when people become aware of cultural differences (the younger nurses) and feel threatened (most likely by their younger age) and respond by ridiculing the beliefs or actions of others to make themselves feel more secure. Cultural assimilation occurs when one adapts to a new culture. Cultural blindness occurs when one ignores a cultural difference. Cultural diversity encompasses culture, race, ethnicity, religion, language, gender, socioeconomic status, and more.

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue? a. Ethnocentrism b. Ageism c. Generalization d. Culture shock

D Culture shock is bewilderment over behavior that is culturally atypical for the client. The client who recently immigrated from another country would experience culture shock over being in a new culture, including a new culture of health care in the new country of residence. Ethnocentrism is the belief that one's culture is better than other cultures. Generalization is the belief that a person shares cultural characteristics with others from a similar background. Ageism is a negative belief that older adults are physically and cognitively impaired.

The nurse is preparing the discharge plan for a new mother and her newborn son. Which new teaching should the nurse ensure is included after noting the family is Jewish? a. when to schedule the next follow-up appointment b. proper breastfeeding techniques c. the proper sleeping position for the newborn d. care following the scheduled circumcision

D Orthodox Judaism and some members of non-orthodox Jewish denominations consider circumcision as a sacred ritual which is performed on the 8th day of the infant's life. Clients of other faiths may request the circumcision be completed before the newborn is discharged home from the hospital and some will choose not to circumcise their newborn. The other choices should be part of every client's discharge teaching.

A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating? a. Cultural diversity b. Stereotyping c. Ethnocentrism d. Cultural blindness

D The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist.

The nurse is caring for a client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse? a. "You should consider eating the food provided, which is healthier." b. "It is ok to eat what your family brought you, as long as we see what it is." c. "Do you understand the specific diet for your HTN?" d. "Can you tell me what foods you prefer to eat and what your family is bringing you?"

D The nurse should attempt to provide culturally sensitive food; however, the nurse should assess what foods the client wants to eat. The nurse should educate the client on food preferences that are also appropriate to the disease-specific dietary restrictions. Even though the diet may be healthier, the nurse should first assess the client's preferences. The nurse should verify the client's understanding of the diet but should avoid closed-ended questions such as asking if the client understands the specific diet for HTN.

A community health nurse is providing care to a group of Hispanic people living in an area that is predominantly populated by white people. What are the Hispanic people in this community an example of? a. A subculture b. A subgroup c. A majority d. A minority

D The term minority refers to a group of people whose physical and cultural characteristics differ from the majority of people in a society. Subcultures are relatively large groups of people who are members of an even larger cultural group but who have certain ethnic, occupational, or physical characteristics that are not common to that larger group. A subgroup is a division of a group that is in some way distinguished from the larger group. A majority is most of the people in a large group.

ethnicity

sense of identification that a cultural group collectively has; the sharing of common and unique cultural and social beliefs and behavior patterns, including language and dialect, religious practices, literature, folklore, music, political interests, food preferences, and employment patterns

culture

sum total of human behavior or social characteristics particular to a specific group and passed from generation to generation or from one to another within the group